HomeMy WebLinkAbout07-23-19 Board of Ethics - Packet Materials - Financial Disclosure Form ...
REPORT TO: Board of Ethics
FROM: Robin Crough, City Clerk
SUBJECT: Financial Disclosure Form – Required Citizen Advisory
Boards
MEETING DATE: July 23, 2019
RECOMMENDATION: Provide official direction on which citizen advisory boards to
include during the annual solicitation to complete the Financial Disclosure Form.
BACKGROUND: Bozeman Municipal Code Sec. 2.03.550. – Financial disclosure
statement reads 3. Who must file financial statements. Financial statements must
be filed by the members of the city commission, the city manager, department heads
and other major financial decision makers which may include members of the
library board and parking commission.
Other boards have been determined to be major financial decision makers by the
City Clerk and City Attorney, as they approve contracts, incentives, and allocation of
TIF funds. These include:
Bozeman Downtown Business Improvement District Board (BDBID)
Bozeman Tourism Business Improvement District (BTBID) (pending dissolution)
Downtown Urban Renewal District Board (DURB)
Library Board of Trustees
Midtown Urban Renewal District Board (MURB)
Northeast Urban Renewal District Board (NURB)
Parking Commission
City Commission
Consistency with collection of these forms (both which boards and ensuring
completion) has been spotty over the years. During recent years, the City Clerk’s
office has incorporated the above boards, and has significantly increased the
completion rate. Due to increased efforts and likely general acceptance by board
members that this is now a requirement, the City had a 100% completion rate for all
board members in 2019.
Because both Bozeman Municipal Code and the legislative history have been unclear
about exactly which boards should complete this form, now is an appropriate time
to have a more official determination.
UNRESOLVED ISSUES: None.
ALTERNATIVES: As determined by the Board of Ethics.
FISCAL EFFECTS: None.
ATTACHMENTS: Financial Disclosure Form
Report compiled on: 7/17/2019
V. 03-2018 1
City of Bozeman
Financial Disclosure Statement
Required by Sect. 2.01.100 of Ordinance No. 1759 and the City Charter
Introduction:
The City of Bozeman and the Bozeman Board of Ethics would like to help individuals understand the
need to complete the attached Financial Disclosure Statement. Those who serve the City of Bozeman
represent the community by their actions each and every day. The public deserves to be represented
by individuals that are free from conflicts of interest. With the completion of a Financial Disclosure
Statement, individuals are further indicating to the community a responsibility to be above reproach in
their financial affairs. With the annual completion of the financial statement, the signer will be
reminded of the need to avoid financial conflicts of interest in fact or in appearance.
Montana’s public records laws require that, once signed, these forms are on file in the City Clerk’s office,
for review by the public. This is not meant to discourage individuals from participating in City
government, but is meant to assure the public that relationships that may be of concern are properly
disclosed.
A list of individuals who are required to fill out this form will be prepared each year and will be on file
with the City Clerk. Persons required to file will receive mailed notice each year.
This form must be filled out annually by those who are “major financial decision makers:”
All City Commission Members, the City Manager, and Department Directors; and
Any employee or board member who is an “authorized signatory” for claims approval,
according to the official signatory forms in the finance office; and
Members of City boards that have expanded financial authority (not just advisory roles):
o Library Board of Trustees
o Parking Commission
o All Business Improvement District Boards
o All Urban Renewal District Boards
ANNUAL DISCLOSURE STATEMENT FOR THE YEAR BEGINNING JANUARY ________.
Return to: Bozeman City Clerk, 121 N Rouse, PO Box 1230, Bozeman, MT 59771
Section 1. IDENTIFICATION
Name: _______________________________________________________________________________
Address of Permanent Residence:_________________________________________________________
Current Position with City of Bozeman: _____________________________________________________
Section 2. BENEFITS CURRENTLY RECEIVED FROM EMPLOYERS (Present & Past)
I currently receive salary and/or benefits (health insurance, retirement payments, retirement accounts
that continue to accrue interest, dividends, or shares, etc.) from the following present or past
employers:
1. Name of Employer: __________________________________________________________________
Employer’s Address:____________________________________________________________________
Type of Benefits_______________________________________________________________________
2. Name of Employer: __________________________________________________________________
Employer’s Address:____________________________________________________________________
Type of Benefits_______________________________________________________________________
Section 3. BUSINESS INTERESTS
I hold an ownership interest of 10% or more in the following businesses (including self-employed
occupations), firms, corporations, partnerships or other businesses or professional entities or trusts.
1. Name of Business: ___________________________________________________________________
Address: __________________________________________ Type of Business:____________________
2. Name of Business: ___________________________________________________________________
Address: __________________________________________ Type of Business:____________________
3. Name of Business: ___________________________________________________________________
Address: __________________________________________ Type of Business:____________________
4. Name of Business: ___________________________________________________________________
Address: __________________________________________ Type of Business:____________________
V. 03-2018 2
V. 03-2018 3
Section 4. POSITIONS HELD WITH OTHER GOVERNMENTS, NON-PROFITS, BOARDS OF DIRECTORS,
ETC.
In addition my current position with the City of Bozeman, I am also currently an officer, director, or
registered agent for the following entities (including non-profits, government boards, private boards,
etc.)
1. Name of Organization ___________________________________Office Held: ___________________
Address:______________________________________________________________________________
2. Name of Organization ___________________________________Office Held: ___________________
Address:______________________________________________________________________________
3. Name of Organization ___________________________________Office Held: ___________________
Address:______________________________________________________________________________
4. Name of Organization ___________________________________Office Held: ___________________
Address:______________________________________________________________________________
Section 5. REAL PROPERTY
Not including my home, I, as an individual, own or have an interest of 10% or more in the following
real property. This includes property that I own outright, under a mortgage, leased, held in trust, is
owned as a tenant in common or owned jointly with other individuals. (Indicate whether the nature of
the interest is investment, vacation, business/commercial, timeshare, etc.) Attach list if necessary.
1.Address of the Property: _____________________________________________________________
Nature of Interest Held in the Property: ___________________________________________________
2. Address of the Property: _____________________________________________________________
Nature of Interest Held in the Property: ___________________________________________________
3. Address of the Property: _____________________________________________________________
Nature of Interest Held in the Property: ___________________________________________________
4. Address of the Property: _____________________________________________________________
Nature of Interest Held in the Property: ___________________________________________________
V. 03-2018 4
Section 6. OTHER
OPTIONAL : I would like to take this opportunity to disclose the following relationships that may be
perceived as a conflict in the function of my duties. (ie. Spousal or familial relationships, past employers
that I no longer work for, other items that are not required to be disclosed above, etc.)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Section 7. CERTIFICATION
I hereby certify that the foregoing statements are true and complete to the best of my knowledge. I
also understand that filing of this statement DOES NOT release me from the requirements to disclose
upon the record and/or abstain from voting in matters where I have a conflict of interest.
_________________________________________________ ________________________
Signature Date
***Print and sign. Clerk must receive an original signed form.